| 1. |
- Holmqvist, Gärd, 1950-, et al.
(författare)
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Expressions of vitality affects and basic affects during art therapy and their meaning for inner change
- 2019
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Ingår i: International Journal of Art Therapy. - Abingdon : Taylor & Francis. - 1745-4832 .- 1745-4840. ; 24:1, s. 30-39
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to describe the occurrence of vitality affects and basic affects and to shed light on their importance in terms of patients' inner change through art therapy. In an earlier study, where 17 women were interviewed about inner change through art therapy, a secondary deductive content analysis of images and statements was performed exploring the presence of vitality affects and basic affects. Nine of the 17 interviews contained clear descriptions of vitality affects and basic affects in the intersubjective communication between the patient and the therapist, these affects were also mirrored in the patients’ painted images.Three cases are used to illustrate the result and how affects were related to inner change. These three cases differ from each other in that they described vitality affects either arising from the art therapist’s empathetic verbal or non-verbal response, from a particular experience in nature, or from the interpreted symbolic language of the image. The common denominator uniting the three cases was the intersubjective communication with the therapist. This study indicates that image making in art therapy gives rise to vitality affects and basic affects that contributes to inner change. It also indicates the importance of having trust in both the method and the art therapist.
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| 2. |
- Milos Nymberg, Veronica, et al.
(författare)
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HEAD-MIP–(HEAlth Dialogues for patients with Mental Illness in Primary care)—a feasibility study
- 2023
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Ingår i: Pilot and Feasibility Studies. - London : BioMed Central (BMC). - 2055-5784. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Patients with mental illness have an increased risk of cardiovascular morbidity and mortality compared to the rest of the population, which is partly related to unhealthy lifestyle habits. To individualise lifestyle counselling in primary care, the Swedish-developed Health Dialogue (HD) can be used as an educative tool at recurrent measurement points with the goal to improve non-healthy lifestyle habits. HD has not been aimed specifically at patients with mental illness, and the effect of a systematic approach with repeated HDs in patients with mental illness in primary care has not been previously studied. The aim of this pilot study was to assess the feasibility of the study design for a larger-scale cohort study using repeated HDs focused on the improvement of lifestyle habits in patients seeking primary care due to anxiety, depression, sleeping problems or stress-related symptoms. Methods: Patients were recruited after a visit to a Primary Health Care Center due to mental illness between October 2019 until November 2021 and received a Health Dialogue, including an assessment of cardiovascular risk factors through a Health Curve. Specific feasibility objectives measured were dropout rate, time to follow-up, and risk improvement rate for different lifestyle changes. Results: A total of 64 patients were recruited and 29 (45%) attended a second HD, with a mean follow-up time of 15 months. All participants had at least one elevated cardiovascular risk level on the Health Curve for the assessed lifestyles. Risk level improvement rate was good except for tobacco use. Conclusion: Despite a higher dropout rate than expected, we suggest that the proposed methodology for a full cohort study within general practice of patients with mental illness in primary care is both acceptable to practice and feasible. © 2023, BioMed Central Ltd., part of Springer Nature.
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| 3. |
- Rask, Mikael, 1958-, et al.
(författare)
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Validity and reliability of a Swedish version of the Relationship Assessment Scale (RAS) : a pilot study
- 2010
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Ingår i: Canadian journal of cardiovascular nursing. - Ottawa : Canadian Council of Cardiovascular Nurses. - 0843-6096. ; 20:1, s. 16-21
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: There is a need for a short and easily administered scale, in the Swedish language, for assessing partner relationships in the health care of persons with cardiac disease. PURPOSE: To establish the reliability and validity of the Swedish version of the Relationship Assessment Scale (RAS). DESIGN: The present pilot study has a methodological design. FINDINGS: Content validity has been tested for relevance, clarity and readability. The scale was tested for construct validity with explorative factor analysis. The reliability was tested by internal consistency and test-retest analysis. The result showed a two-factor solution, which does not correspond to the original proposed one-factor solution. The factor analyses revealed two quite distinct factors of RAS, labelled "Relationship built on expectations and satisfaction of needs" and "Relationship built on love and devotion". CONCLUSIONS: The scale has satisfactory psychometric properties in terms of content validity, construct validity, homogeneity and stability in a population of persons with cardiac disease. Wider evaluations of the RAS for other populations and settings are recommended.
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| 4. |
- Berg, Marie, 1955, et al.
(författare)
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Breastfeeding and its impact on daily life in women with type 1 diabetes during the first six months after childbirth: a prospective cohort study
- 2012
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Ingår i: International Breastfeeding Journal. - London : Springer Science and Business Media LLC. - 1746-4358. ; 7:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: For mothers with diabetes, breastfeeding is a great challenge due to their struggle with potentially unstable blood glucose levels. This paper explores breastfeeding attitudes and impact of breastfeeding on the daily life of mothers with type 1 diabetes compared with non-diabetic mothers. Methods: We performed a prospective cohort study of 108 mothers with type 1 diabetes and a reference group of 104 mothers in the west of Sweden. Data were collected through medical records and structured telephone interviews at 2 and 6 months after childbirth. Results: Women in both the diabetes group and the reference group had high levels of confidence (84% and 93% respectively) in their breastfeeding capacity before childbirth, and 90% assessed breastfeeding as a positive and an important experience during the six months of follow-up. About 80% assessed breastfeeding as influencing daily life ‘very much’ or ‘quite a lot’ at 2 months as did 60% at 6 months, with no difference between the groups. Inmothers with diabetes, the impact of breastfeeding on the priority of other duties decreased over time, as did feelings of time pressure and negative effects on patterns of sleep. Compared to the reference group, mothers with diabetes at 6 months remained more affected by disruptions in daily life and they felt more worried about their health both at 2 and 6 months after childbirth. For the reference group mothers’ sensitivity to unexpected disruptions in daily routines decreased between 2 and 6 months after childbirth, and they expressed a greater need to organize their time than mothers with diabetes. Conclusion: Mothers with diabetes type 1 express more worry for own health and are more sensitive to distruptions. To balance their everyday life and to reduce the risk of stress and illhealth they are therefor, compared to other mothers, likely to need additional professional and peer support.
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| 5. |
- Haglund, Emma, 1970-, et al.
(författare)
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Predictors of Presenteeism and Activity Impairment Outside Work in Patients with Spondyloarthritis
- 2015
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Ingår i: Journal of occupational rehabilitation. - New York, NY : Springer-Verlag New York. - 1053-0487 .- 1573-3688. ; 25:2, s. 288-295
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Tidskriftsartikel (refereegranskat)abstract
- Purposes To assess predictors of presenteeism (reduced productivity at work) and activity impairment outside work in patients with spondyloarthritis (SpA). Methods Multivariate logistic regression analysis was used to study predictors of presenteeism and activity impairment in 1,253 patients with SpA based on a 2.5 year follow-up questionnaire. The Work Productivity and Activity Impairment (WPAI) questionnaire was used as main outcome. Age, gender, lifestyle factors, subgroups, disease duration, and different patient reported outcome measures (PROMs) were studied as possible predictors. The association between presenteeism and WPAI activity impairment outside work was assessed. Results Out of 1,253 patients, 757 reported being in work and of these 720 responded to the WPAI questionnaire. The mean (confidence interval, CI) reported presenteeism was 25 % (23-27 %) and mean activity impairment 33 % (31-35 %) (0-100 %, 0 = no reduction). Significant predictors of presenteeism and activity impairment at follow-up (controlled for gender, age, spondyloarthritis subgroups and presenteeism at baseline) were presenteeism at baseline, poor quality of life, worse disease activity, decreased physical function, lower self-efficacy pain and symptom, higher scores of anxiety, depression, smoking and low education level, and for activity impairment also female sex. There was a strong association between presenteeism and activity impairment outside work (OR 16.7; 95 % CI 11.6-24.3; p < 0.001). Conclusions Presenteeism and activity impairment were not only predicted by presenteeism at baseline, but also by several PROMs commonly used in clinical rheumatology practice. Impaired activity outside work could indicate problems also at work suggesting why both areas need to be addressed in the clinical situation. © 2014, Springer Science+Business Media New York.
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| 6. |
- Haglund, Emma, et al.
(författare)
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Work productivity in a population-based cohort of patients with spondyloarthritis
- 2013
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Ingår i: Rheumatology. - Oxford : Oxford University Press (OUP). - 1462-0324 .- 1462-0332. ; 52:9, s. 1708-1714
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Tidskriftsartikel (refereegranskat)abstract
- Objective. To assess work productivity and associated factors in patients with SpA. Methods. This cross-sectional postal survey included 1773 patients with SpA identified in a regional health care register. Items on presenteeism (reduced productivity at work, 0-100%, 0 = no reduction) were answered by 1447 individuals. Absenteeism was defined as register-based sick leave using data from a national register. Disease duration, disease activity (BASDAI), physical function (BASFI), health-related quality of life (EQ-5D), anxiety (HAD-a), depression (HAD-d), self-efficacy [Arthritis Self-efficacy Scale (ASES) pain and symptom], physical activity and education were also measured. Results. Forty-five per cent reported reduced productivity at work with a mean reduction of 20% (95% CI 18, 21) and women reported a higher mean reduction than men (mean 23% vs 17%, P < 0.001). Worse quality of life, disease activity, physical function and anxiety all correlated with reduced productivity (r = 0.52-0.66, P < 0.001), while sick leave did not. Worse outcomes on the EQ-5D (beta-est -9.6, P < 0.001), BASDAI (beta-est 7.8, P < 0.001), BASFI (beta-est 7.3, P < 0.001), ASES pain (beta-est -0.5, P < 0.001) and HAD-d (beta-est 3.4, P < 0.001) were associated with reduced productivity at work in patients with SpA regardless of age, gender and disease subgroup. ASES symptoms, HAD-a and education level < 12 years were associated with reduced productivity but were not significant in all strata for age, gender and disease subgroup. Conclusion. Work productivity was reduced in patients with SpA and more so in women. Worse quality of life, disease activity, physical function, self-efficacy and depression were all associated with reduced productivity at work in patients with SpA.
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| 7. |
- Hallberg, Lillemor R-M, 1942, et al.
(författare)
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Facing a moral dilemma--introducing a dental care insurance within the public dental service.
- 2012
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Ingår i: Swedish dental journal. - : Swedish dental journal. - 0347-9994. ; 36:3, s. 149-56
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Tidskriftsartikel (refereegranskat)abstract
- Through the reform entitled "Dental care insurance-dental care at a fixed price", patients are offered a dental insurance, a capitation plan, that ensures that they can visit the dentist regularly during a period of three years at a fixed price per month (Frisktandvård).This insurance may be offered to all patients. The aim of this study was to generate a theory explaining the main concern for the staff at the public dental service when they have to introduce and advocate dental care insurance to patients. Interview data from 17 persons, representing different professions within the public dental service, were collected and analyzed simultaneously in line with guidelines for grounded theory. The results indicated that dentists/dental hygienists experienced several difficult standpoints concerning the implementation of the dental insurance, somewhat of a moral dilemma. The staff generally had a "cautiously positive attitude" to the forthcoming dental care insurance, but had perceptions how and when the patients should be offered the insurance and what that may mean to the clinic.The respondents reflected about the economic aspects for the clinic and how the oral health may be affected over time for the patients.
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| 8. |
- Karlsson, Staffan, 1959-, et al.
(författare)
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Trends in treatment with antipsychotic medication in relation to national directives, in people with dementia : a review of the Swedish context
- 2017
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Ingår i: BMC Psychiatry. - London : BioMed Central. - 1471-244X. ; 17, s. 1-9
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Forskningsöversikt (refereegranskat)abstract
- Background: The aim of this study was to explore trends in treatment with antipsychotic medication in Swedish dementia care in nursing homes as reported in the most recent empirical studies on the topic, and to relate these trends to directives from the national authorities. Methods: The study included two scoping review studies based on searches of electronic databases as well as the Swedish directives in the field. Results: During the past decade, directives have been developed for antipsychotic medication in Sweden. These directives were generic at first, but have become increasingly specific and restrictive with time. The scoping review showed that treatment with antipsychotic drugs varied between 6% and 38%, and was higher in younger older persons and in those with moderate cognitive impairment and living in nursing homes for people with dementia. A decreasing trend in antipsychotic use has been seen over the last 15 years. Conclusions: Directives from the authorities in Sweden may have had an impact on treatment with antipsychotic medication for people with dementia. Treatment with antipsychotic medication has decreased, while treatment with combinations of psychotropic medications is common. National directives may possibly be even more effective, if applied in combination with systematic follow-ups.
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| 9. |
- Andersson, Maria L.E. 1968-, et al.
(författare)
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Associations between chronic widespread pain, pressure pain thresholds, leptin, and metabolic factors in individuals with knee pain
- 2023
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Ingår i: BMC Musculoskeletal Disorders. - London : BioMed Central (BMC). - 1471-2474. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aim was to study associations between chronic widespread pain, widespread pain sensitivity, leptin, and metabolic factors in individuals with knee pain. A secondary aim was to study these associations in a subgroup of individuals with normal BMI.METHOD: This cross-sectional study included 265 individuals. The participants were categorised into three different pain groups: Chronic widespread pain (CWP), chronic regional pain (ChRP), or no chronic pain (NCP). The pressure pain thresholds (PPTs) were assessed using computerised pressure algometry. Low PPTs were defined as having PPTs in the lowest third of all tender points. Leptin and metabolic factors such as BMI, visceral fat area (VFA), lipids, and glucose were also assessed.RESULT: Sixteen per cent reported CWP, 15% had low PPTs, and 4% fulfilled both criteria. Those who fulfilled the criteria for CWP were more often women, more obese, and had increased leptin levels. In logistic regression, adjusted for age and gender, leptin was associated with fulfilling criteria for CWP, OR 1.015 (95% CI 1.004-1.027, p = 0.008). In logistic regression, adjusted for age and gender, leptin was associated with low PPTs, OR 1.016 (95% CI 1.004-1.029, p = 0.012). Leptin was also associated with fulfilling both criteria, adjusted for age, sex, and visceral fat area (VFA), OR 1.030 (95% CI 1.001-1.060), p = 0.040.CONCLUSION: Leptin was associated with fulfilling the combined criteria for chronic widespread pain and low PPTs, even after adjusting for the visceral fat area (VFA). Longitudinal studies are needed to study the causal relationships between leptin and the development of widespread pain.
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| 10. |
- Grotle, Margreth, et al.
(författare)
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What's in the black box of arthritis rehabilitation? : A comparison of rehabilitation practice for patients with inflammatory arthritis in northern europe
- 2013
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Ingår i: Journal of Rehabilitation Medicine. - Uppsala : Foundation Rehabilitation Information. - 1650-1977 .- 1651-2081. ; 45:5, s. 458-466
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Tidskriftsartikel (refereegranskat)abstract
- Background: In evaluating complex interventions, it is a challenge for researchers to provide transparent reporting of the intervention content with sufficient detail and clarity such that effects can be compared across studies or countries. Objective: To describe and compare the content of current rehabilitation for patients with inflammatory arthritis across 4 northern European countries. Patients and methods: A total of 731 patients with inflammatory rheumatic diseases participated in a multicentre, longitudinal observational study carried out in Sweden, The Netherlands, Denmark and Norway. Data on context, structure and process were reported by patients and teams at the different participating study sites according to the Scandinavian Team Arthritis Register European Team Intiative for Care Research (STAR-ETIC) framework. Results: Although large similarities were found in the context, there were important differences between the Netherlands and the Scandinavian countries. Regarding structure, there were considerable differences in the length of the rehabilitation period across settings and countries. The most evident differences concerned process variables, especially the type and dosage of individual treatment modalities. Conclusion: The variation in important aspects of arthritis rehabilitation found in the present study underline the need for transparent and standardized description of these variables when comparing effects across settings and countries. A standardized description of current practice can be achieved by the STAR-ETIC framework.
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